Provider Demographics
NPI:1790059798
Name:PITKOFF, DONNA M (MS LPC,)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:PITKOFF
Suffix:
Gender:F
Credentials:MS LPC,
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 CREEKSIDE DR
Mailing Address - Street 2:SUITE 601
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-9204
Mailing Address - Country:US
Mailing Address - Phone:610-326-2728
Mailing Address - Fax:610-326-2750
Practice Address - Street 1:600 CREEKSIDE DR
Practice Address - Street 2:SUITE 601
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9204
Practice Address - Country:US
Practice Address - Phone:610-326-2728
Practice Address - Fax:610-326-2750
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1245267129OtherGROUP NPI # INNOVATIVE COUNSELING ASSOCIATES
PAPC003480OtherPENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS